Can You Safely Have an Abortion at Home? Risks, Procedure, and Aftercare

An abortion, or pregnancy termination, can take place at home or in a healthcare setting. This depends on how early or advanced the pregnancy is. Up to 10 weeks into a pregnancy, it’s possible — and safe — to have an abortion at home with pills. This is also called a medication abortion or medical abortion. 

After 10 weeks, depending on where you live, it’s still possible to have a medication abortion in a healthcare facility. But after 12 weeks, the only option for ending a pregnancy is through a surgical procedure in a healthcare clinic.   

Here’s a look at how home abortions work, the medications used, and when it’s safe to have one. 

Are at-home medication abortions safe?

Yes, home medication abortions are safe. In the U.S., pregnancy can be terminated safely and legally at home up to week 10 of pregnancy. The FDA has approved a medication regimen for up to 10 weeks (70 days or less since your last menstrual period). But some places may give it beyond this. 

The only safe way to have an abortion at home is with medications prescribed by a trained medical professional after a consultation. The consultation may be in person at a hospital or clinic. This can also happen by phone or a telehealth appointment.

Are at-home abortions legal?

At-home abortions for pregnancies 10 weeks or less are legal in most states in the U.S. But laws are changing around this. Even in states where at-home abortions are legal, laws may now require a physician to be present when you take the first medication. 

Afterward, you can usually go home and wait for the medication to take effect. And you can take the second medication at home. 

How do you have a medication abortion at home?

A medication (home) abortion involves taking two medications. Unlike a surgical abortion, which is a same-day procedure, a medication abortion takes longer. 

Typically, you’ll manage the outcome and symptoms at home over 2 to 3 days. So it’s important to understand the steps and timeline so you know what to expect. 

Step 1: Take mifepristone

Here are the details of the first step:

• Take a 200 mg pill of mifepristone by mouth. 

• Depending on your preference and state laws, this might be at home or in a clinic. 

• This medication stops the pregnancy from growing. 

• There are minimal symptoms at this stage. But you might have some light spotting or cramping.

Step 2: Wait 24 hours 

Here’s what to expect next:

• This is a good time to rest and prepare for the next couple of days.

• Make sure you have supplies, like sanitary pads, a heating pad, and acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). 

• Try to anticipate what kind of emotional support you may need. You may want to be alone, or you may want to have a support person there with you.

Step 3: Take misoprostol

Here’s what happens next:

• Take four 800 mcg pills of misoprostol. These pills can be placed in your vagina, under the tongue, or inside the cheeks. 

• Misoprostol starts to work within a few hours. 

• This medication will cause some cramping and bleeding that will push the pregnancy out of your body.

Step 4: Manage symptoms at home

Here are the details of the fourth step:

• Cramping and bleeding will be most intense the first day. 

• You may also experience some diarrhea, nausea, dizziness, or fatigue in the first 24 hours. 

• You’ll want to be near a bathroom and have acetaminophen or ibuprofen available if needed. 

• Symptoms should lighten up over the following days. 

• Some cramping and bleeding will likely continue for up to a few weeks. 

Step 5: Take a pregnancy test

Here are the details of the last step:

• Around 2 weeks later, take a pregnancy test to make sure the abortion is completed. 

• Make a plan for the birth control option that’s best for you.  

How does the abortion pill work?

Medical abortions usually involve a combination of two pill medications that work together to end a pregnancy: 

• The first medication, mifepristone, blocks the main hormone (progesterone) that maintains the pregnancy. 

• The second medication, misoprostol, causes contractions (cramping) that empty the uterus. It usually causes vaginal bleeding, like a heavy period, within 4 to 6 hours after you take it. 

The two-step medication abortion takes between 2 and 3 days to work. But you will likely have a longer period of light bleeding or cramping. If you were experiencing pregnancy symptoms such as nausea or vomiting, these symptoms should go away within a couple days after the abortion.

How effective are home abortions?

The two-step abortion medication is 96.7% effective. If it doesn’t work and you don’t get a heavy bleed removing the pregnancy, then some people need another dose of misoprostol or a surgical procedure (surgical abortion) to end the pregnancy. The further along you are in your pregnancy, the more risk there is that a medication abortion might not work. 

Home abortion aftercare

Bleeding and cramping will lessen over the first few days after a medical abortion. But it’s very normal and expected to have some light bleeding and cramping for a few weeks after. 

Take care of yourself as you recover. This means getting plenty of rest, managing your symptoms, and tending to your emotions, too. 

Here’s what that may look like in practice: 

• Take 1 to 2 days off work and school. And get help with normal duties if you can. You can return to normal activities as you feel ready over the next few days. 

• Take over-the-counter medications like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) for pain.

• Use a hot water bottle or heating pad to ease cramping or discomfort. 

• Take a warm shower.

Watch for signs of complications or signs that the abortion may not have completed. Contact your primary healthcare provider or an abortion clinic if your bleeding and cramping get worse instead of better or if you develop new symptoms. 

You may feel many different emotions, from sadness to relief. If you have a partner and/or supportive friends and family, it can be helpful to talk about what you’re feeling. If your emotions are getting in the way of your recovery — be sure to get the help you need.

Do you need a prescription for the abortion pill?

Yes. The FDA regulates the abortion pill, and you need a prescription for it. In some states, a physician must write the prescription. This means that nurse practitioners, physician assistants, and midwives can’t issue the medications. And in some states the law states that a person must take the medications under direct physician supervision.

Where can you get the abortion pill?

Where you can get the abortion pill will depend on where you live. In states where telehealth abortion is legal, you can get abortion pills online and through the mail. In other states, you may be able to get them in person at a clinic. 

Some states have more restrictions, and some states have even banned abortions. Your local Planned Parenthood or AbortionFinder.org are good places to learn more about local resources and options in your area.

Who should not have an at-home medication abortion?

Some people should not have a medication abortion at home. Healthcare professionals do not recommend medication abortion for people with any of these risk factors:

• A pregnancy that is too far along (usually over 10 weeks)

• An ectopic pregnancy (a pregnancy outside of the uterus)

• An intrauterine device (IUD) in place

• A hormonal imbalance, such as from adrenal gland problems or long-term corticosteroid use

• Bleeding problems, such as clotting disorders or concurrent use of blood thinners

• Allergies to either mifepristone or misoprostol

What are the risks of an at-home medication abortion?

An at-home medication abortion under the guidance of a trained healthcare professional has minimal risks. Many people experience bleeding and cramping after ending a pregnancy. This is a normal part of the uterus returning to its nonpregnant state.

But you should get medical care if bleeding is severe and you soak more than one tampon or pad every hour. If the uterus doesn’t completely empty itself with the medication abortion, then a surgical procedure may be needed to end the pregnancy. This happens in about 2% of cases. 

Infections are rare with medication abortions. But they can happen if the uterus doesn’t fully empty and the cervix doesn’t close completely. Look for warning signs like fever, severe pain, a bad-smelling vaginal discharge, fatigue, or chills. These signs may mean you need follow-up emergency medical care.

The risk of death from a legal medication abortion under the supervision of a trained provider is 0.1 in every 100,000 abortions. With unsafe abortions, the risk of death goes up to 350 in every 100,000 abortions worldwide.

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Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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